住院新生儿多药耐药菌医院感染耐药性分析

Clinical analysis of multidrug-resistant bacteria infections in hospitalized neonates

目的分析医院新生儿病房多药耐药菌感染及对抗菌药物耐药性,为临床合理用药及降低医院感染发生率提供参考依据。方法对医院2010年5月-2011年12月64例患儿的感染资料进行回顾性分析。结果 64例患儿肺炎48例,败血症10例,化脓性脑膜炎、泌尿系统感染及脐炎各2例;排名前3位的病原菌依次为肺炎克雷伯菌、大肠埃希菌、表皮葡萄球菌,分别占45.71%、31.43%、8.57%;肺炎克雷伯菌、大肠埃希菌对氨苄西林、氨苄西林/舒巴坦、头孢菌素类、氨曲南100.0%耐药,表皮葡萄球菌、溶血葡萄球菌对青霉素、苯唑西林、红霉素、头孢唑林等100.0%耐药。结论多药耐药菌以医院感染病原菌为主,主要感染部位为肺部、血液、泌尿道,应加强多药耐药菌监测与控制,合理应用抗菌药物,对早产儿、极低出生体重儿,应缩短住院时间,不主张预防性使用抗菌药物。

OBJECTIVE To analyze the incidence of multidrug-resistant bacteria infections in neonatal wards and ob- serve the drug resistance so as to provide guidance for reasonable clinical use of antibiotics and reduction of inci- dence of nosocomial infections. METHODS A retrospective analysis was conducted on the medical records of 64 in- fected children from May 2010 to Dec. 2011. RESULTS In the 64 patients, there were 48 cases of pneumonia,10 ca- ses of sepsis, 2 cases of purulent meningitis, 2 cases of urinary tract infections, 2 cases of omphalitis. The top three pathogens were as follows： Klebsiella pneumoniae（45.71%）, Escherichia coli （31.43%）, Staphylococcus epidermidis （8.57 %）. The drug resistance rates of K. pneurnonia e and E. coli to ampicillin, ampicillin-sulbactam, cephalosporins, and aztreonam were up to 100. 0% the drug resistance rates of the S. epidermidis and Staphylo- coccus haemolyticus to penicillin, oxacillin, erythromycin, and cefazolin were 100.0%. CONCLUSION The multi- drug-resistant bacteria are dominant among the pathogens causing the nosocomial infections, and the main infection sites are lungs, blood, and urinary tract. It is necessary to strengthen the monitoring and control of multidrug-re- sistant bacteria, reasonably use antibiotics, and shorten the hospitalization duration of preterm Or low birth weight neonates, and the prophylactic use of antibiotics shall not be recommended.